The most widely used stimulant in the world is probably caffeine. The American College of Sports Medicine reports that moderate doses of caffeine increase athletes’ performance. The Olympics do not ban caffeine but student athletes may be disqualified by the National Collegiate Athletic Association (NCAA) if their urine contains more than 15 mcg/mi of caffeine.
Caffeine OK Drug for Athletes

That is a lot of caffeine. According to Dorothy Mills-Gregg, writing for the Sacramento Bee, the NCAA estimates that an athlete would have to take in 17 caffeinated soft drinks to put him or her over the limit. Mills-Greg quoted Kathleen Deegan, a registered dietitian and nutrition professor at California State University, Sacramento, as saying that caffeine gives athletes a heightened sense of well-being and a decreased perception of exertion.
“In other words, ” she told Mills-Greg, “they don’t hurt, so they can work out longer and harder.” Deegan, who is the nutritionist for all the Sac State sports teams, said that the feeling of energy comes from the body’s reaction to the caffeine, which increases heart rate and the amount of blood being pumped. Consuming too much caffeine, she theorized, could induce athletes to push themselves to the point where they get injured.
Mills-Gregg reports that the American College of Sports Medicine holds that benefits have been found when athletes consume anywhere from 3 mg to 9 mg of caffeine per kilogram of body weight. That is the equivalent of two to six cups of coffee.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.